早卵泡期长效长方案与拮抗剂方案在卵巢正常反应患者中的应用效果比较  

Comparison of effect of early follicular phase long-acting long protocol and antagonist protocol in the treatment of patients with normal ovarian response

作　　者：马紫玮 南燕[1] 王慧[1] 于莲 李玉洁[1] MA Ziwei;NAN Yan;WANG Hui;YU Lian;LI Yujie(Department of Reproductive Medicine,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院生殖医学科,河南新乡453003

出　　处：《新乡医学院学报》2022年第11期1041-1046,共6页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20190490)。

摘　　要：目的比较早卵泡期长效长方案与拮抗剂方案应用于卵巢正常反应(NOR)患者的临床效果。方法选择2017年4月至2021年1月于新乡医学院第三附属医院生殖医学科接受体外受精/单精子卵泡胞浆内注射-胚胎移植助孕治疗的241例NOR患者为研究对象,根据促排卵方案将患者分为长效长方案组(n=164)和拮抗剂方案组(n=77)。长效长方案组患者行早卵泡期长效长方案,拮抗剂方案组患者行促性腺激素释放激素拮抗剂(GnRH-ant)促排卵方案。比较2组患者控制性超促排卵过程中的相关指标[包括重组人促性腺激素(Gn)总量及Gn天数、人绒毛膜促性腺激素(HCG)注射日(HCG日)子宫内膜厚度及HCG日黄体生成素(LH)、雌二醇(E_(2))、黄体酮(P)水平、获卵数、第2次减数分裂(MⅡ)卵母细胞数、双原核(2PN)数、可移植胚胎数、优质胚胎数]、新鲜胚胎移植临床结局相关指标[包括全胚冷冻率、周期取消率、中重度卵巢过度刺激综合征(OHSS)发生率、着床率、生化妊娠率、临床妊娠率、早期流产率、持续妊娠率、活产率]及首次冻融胚胎移植(FET)的相关指标(包括FET日内膜厚度、着床率、生化妊娠率、临床妊娠率、早期流产率、持续妊娠率、活产率)。结果长效长方案组患者的Gn天数、HCG日内膜厚度、获卵数、MⅡ卵母细胞数、2PN数、可移植胚胎数、优质胚胎数均显著高于拮抗剂方案组,HCG日LH值显著低于拮抗剂方案组(P<0.05);长效长方案组与拮抗剂方案组患者Gn应用总量、HCG日E_(2)水平、HCG日P水平、优胚率比较差异无统计学意义(P>0.05)。新鲜胚胎移植周期,长效长方案组与拮抗剂方案组中重度OHSS发生率、周期取消率、胚胎着床率、临床妊娠率、生化妊娠率、早期流产率、持续妊娠率及活产率比较差异均无统计学意义(P>0.05),长效长方案组全胚冷冻率显著低于拮抗剂方案组(P<0.05)。首次FET周期,长效长方�Objective To compare the clinical effects of early follicular phase long-acting long protocol and antagonist protocol in patients with normal ovarian response(NOR).Methods A total of 241 patients with NOR who underwent in vitro fertilization/single sperm follicular intracytoplasmic injection-embryo transfer for fertility treatment at the Department of Reproductive Medicine,the Third Affiliated Hospital of Xinxiang Medical University from April 2017 to January 2021 were selected as the research subjects,and the patients were divided into the long-acting long protocol group(n=164)and the antagonist protocol group(n=77)according to the ovulation promotion protocols.The patients in the long-acting long protocol group underwent early follicular phase long-acting long protocol,the patients in the antagonist protocol group underwent gonadotropin-releasing hormone antagonist(GnRH-ant)ovulation promotion protocol.The related indexes in controlled ovarian hyperstimulation[including the total amount of recombinant human gonadotropin(GN)and the number of GN days,the endometrial thickness,the levels of luteinizing hormone(LH),estradiol(E_(2)),progesterone(P)on the human chorionic gonadotropin(HCG)injection day(HCG-day),the number of eggs retrieved,the number of oocytes in the metaphase Ⅱ(MⅡ),the number of double pronuclear(2PN),the number of transplantable embryos,and the number of high-quality embryos],the clinical outcomes indicators in fresh embryo transfer cycles[including whole embryo freezing rate,cycle cancellation rate,incidence of moderate to severe ovarian hyperstimulation syndrome(OHSS),implantation rate,biochemical pregnancy rate,clinical pregnancy rate,early abortion rate,sustained pregnancy rate,live birth rate]and relevant indicators in first frozen-thawed embryo transfer(FET)cycles(including endometrial thickness on the FET-day,implantation rate,biochemical pregnancy rate,clinical pregnancy rate,early miscarriage rate,persistent pregnancy rate,and live birth rate)of patients between the two groups were com

关 键 词：卵巢正常反应 早卵泡期长效长方案 拮抗剂方案 冻融周期 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]